Aljoša Matejčić1, Mihovil Ivica1, Darko Jurišić2, Tomislav Ćuti3, Bore Bakota4, Dinko Vidović5. 1. University Hospital "Sisters of Mercy", Department of Trauma and Orthopaedic Reconstructive Surgery, Vinogradska cesta 29, 10000 Zagreb, Croatia. 2. General Hospital "Josip Benčević", Andrije Štampara 42, 35000 Slavonski Brod, Croatia. 3. University Hospital "Sisters of Mercy", Clinic for Traumatology, Draškovićeva 19, 10000 Zagreb, Croatia. 4. Department of Surgery, General Hospital Karlovac, Dr. Andrije Štampara 3, 47000 Karlovac, Croatia. 5. University Hospital "Sisters of Mercy", Department of Trauma and Orthopaedic Reconstructive Surgery, Vinogradska cesta 29, 10000 Zagreb, Croatia. Electronic address: dinko.vidovic@gmail.com.
Abstract
INTRODUCTION: Comminution of the patellar apex is amenable to internal fixation by standard techniques and usually requires partial patellectomy. In our institution, multifragmentary fractures of the distal pole are treated with the basket plate, which is shaped to fit the geometry of the patellar apex. This implant has been used in our institution for over 25 years. The aim of this study was to evaluate long-term results of internal fixation of comminuted fractures of the patellar apex with the basket plate. MATERIALS AND METHODS: A total of 142 patients with fracture of the distal pole of the patella were treated with the basket plate between 1988 and 2013. Functional evaluation was conducted using the modified Cincinnati knee rating system. A total of 98 patients were available for late functional evaluation. RESULTS: There were no infections or implant-related problems during the follow-up period. All fractures healed within 8 to 10 weeks. There were three cases of early revision because of improper use of the implant and incorrect indication. Functional outcome following internal fixation with the basket plate was excellent in 80 patients and good in 18; there were no poor results. CONCLUSION: Internal fixation with the basket plate is recommended for management of multifragmentary fractures of the patellar apex because this method enables early, unrestricted knee motion, and provides reliable healing and good functional outcome. This method is an alternative to partial patellectomy and is considered a patella-saving procedure; therefore, the use of the basket plate is strongly recommended for the treatment of distal pole fractures.
INTRODUCTION: Comminution of the patellar apex is amenable to internal fixation by standard techniques and usually requires partial patellectomy. In our institution, multifragmentary fractures of the distal pole are treated with the basket plate, which is shaped to fit the geometry of the patellar apex. This implant has been used in our institution for over 25 years. The aim of this study was to evaluate long-term results of internal fixation of comminuted fractures of the patellar apex with the basket plate. MATERIALS AND METHODS: A total of 142 patients with fracture of the distal pole of the patella were treated with the basket plate between 1988 and 2013. Functional evaluation was conducted using the modified Cincinnati knee rating system. A total of 98 patients were available for late functional evaluation. RESULTS: There were no infections or implant-related problems during the follow-up period. All fractures healed within 8 to 10 weeks. There were three cases of early revision because of improper use of the implant and incorrect indication. Functional outcome following internal fixation with the basket plate was excellent in 80 patients and good in 18; there were no poor results. CONCLUSION: Internal fixation with the basket plate is recommended for management of multifragmentary fractures of the patellar apex because this method enables early, unrestricted knee motion, and provides reliable healing and good functional outcome. This method is an alternative to partial patellectomy and is considered a patella-saving procedure; therefore, the use of the basket plate is strongly recommended for the treatment of distal pole fractures.
Authors: Rong Chen; Hong Cao; Zhibo Sun; Liangbo Jiang; Xiangwei Li; Lin Zhao; Xinghui Liu Journal: J Orthop Surg Res Date: 2022-02-21 Impact factor: 2.359